Breast reconstruction is a common procedure in Singapore because breast cancer is a relatively common cancer in Singapore. In fact, it is the commonest female cancer in Singapore with an incidence of about 1 in 11 women. The annual number of new breast cancer cases in Singapore is more than 1000, and the number of yearly deaths from breast cancer is more than 400. Patients who require breast reconstruction are those who have undergone a mastectomy for breast cancer. A mastectomy is an operation where the breast containing the cancerous growth is surgically removed. In the old days, the nipple, areola, a substantial amount of skin, and sometimes even the underlying pectoralis major muscle were removed as well. Fortunately, with advances in breast health screening, and early breast cancer detection and diagnosis, such radical and mutilating operations are now rarely required. When breast cancer is picked up early and the tumor is small, it can be surgically removed without removing the entire breast. This is known as a lumpectomy. If it turns out that the entire breast needs to be removed, most cancerous tumors can still be removed using mastectomy techniques that preserve the skin of the breast, the nipple areolar complex, or both. This allows the breast surgeon performing the mastectomy to minimize disfigurement to the breast and chest, and simplifies the task of breast reconstruction by the plastic surgeon. The two modern and common techniques of mastectomy are the skin sparing mastectomy and the nipple sparing mastectomy. The skin sparing mastectomy involves removing the breast and the nipple areolar complex, but preserves all the skin. The nipple sparing mastectomy, also known as a subcutaneous mastectomy, involves removal of the breast tissue only, while sparing the nipple areolar complex and all the skin. The choice between these types of mastectomy will depend on a number of factors such as the size of the tumor, its location, and whether the milk ducts close to the nipple are involved. Upon completion of the mastectomy by the breast surgeon, the plastic surgeon then becomes involved, and his job is to reconstruct the breast to make it look as natural as possible and as symmetric as possible with the opposite breast. The breast can be reconstructed using a breast implant, the patient’s own tissues harvested from another part of the body, or both. Each reconstructive option has its pros and cons, and this will be discussed in detail beforehand so that the patient can make a fully informed choice. If the plan was to reconstruct the breast with an implant but a significant amount of skin had to be removed (which is uncommon nowadays), it may be necessary to first expand the skin gradually with a tissue expander over a period of 8 to 10 weeks before replacing the expander with an implant. This is to compensate for the loss of skin by slowly stretching the remaining skin so that it can subsequently accommodate the breast implant. If no skin was removed, i.e. either a skin sparing or nipple sparing mastectomy had been performed, it should be possible to perform an immediate direct to implant reconstruction without the need for an initial period of tissue expansion. If the choice was to reconstruct the breast with the patient’s own tissues, this is often harvested from the back (the latissimus dorsi muscle flap, with or without an overlying piece of skin), or from the patient’s abdomen (the TRAM flap). In certain cases, the reconstruction may be consisted of a combination of implant and the patient’s own tissues. Again, these reconstructions are usually performed immediately after the mastectomy and during the same operation. Whether the reconstruction is implant based or soft tissue based, fat grafting can be useful ancillary tool to fine tune and enhance the result of the reconstruction. Fat grafting involves removing fat cells from other parts of the body using gentle, non-traumatic liposuction technique, purifying the fat, then injecting the purified fat cells carefully and meticulously in small parcels into the areas that need it. Thus, fat grafting allows the plastic surgeon to add volume and tissue thickness to areas that need it in order to optimize breast size and breast shape and make the result look as natural as possible. It can be considered as an “icing on the cake” procedure that provides enhancement and refinement to the overall result. Regardless of the method of reconstruction, with current advanced techniques and the availability of high quality breast implants such as the Motiva Ergonomix implant, it is often possible to fully reconstruct a breast following mastectomy and produce a new and natural looking breast. Apart from restoring volume and shape in the reconstructed breast, we should also pay attention to the issue of symmetry with the opposite breast. If the opposite breast is significantly different from the reconstructed breast in terms of size or shape, it may be necessary to modify the opposite breast accordingly by performing a breast reduction (if the opposite breast is larger), a breast augmentation (if the opposite breast is smaller), or a breast lift (if the opposite breast is sagging). To find out more about breast augmentation services, visit us at mhplasticsurgery.com.sg
October 15 2020
If you are thinking of getting breast Singapore with breast implants, shape and implant surface is an important factor that you need to consider. It is important to do research and consult with a plastic surgeon so you can make an informed decision when choosing your implant. Different women have different aesthetic goals they want to achieve for their breasts in size and shape. Implant they choose will be very important in influencing the outcome of the surgery. In addition, your own biological factors such as your breasts and chest dimensions and the thickness and elasticity of soft tissues you also need to be considered when choosing the most suitable implant for you. It is therefore important to consult a certified plastic surgeon in Singapore so that he can guide you in choosing the type of breast implant is most suitable for you. This article discusses various breast implant options available in the market today. This will help you to understand the difference between these implants and provide a clear picture of your available options.
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Different Breast Implant Shapes for Breast Enhancement
Currently, three different breast implant shapes are available: round implant, anatomical ( also known as teardrop, Gummy Bear) implant and Motiva Ergonomix®.
Round implants are the original and oldest forms of breast implants. It is shaped like a dome, and equally full in the top and bottom. This implant produces fuller at the top of the breast compared to the other two forms. This creates a fullness profile is slightly convex at the top of the breast when viewed from the side, which is a natural breast that does not have no matter how big might. Therefore, the round implants produce a natural breast profile of at least three forms of the implant. But it tends to produce a more complete cleavage, which some women find desirable. Being a round shape, the implant is also not susceptible to unwanted deformations resulting from the rotation of the implant during or after surgery.
The anatomic implant was created to address the major weaknesses of the implant rotation, namely excessive fullness at the top of the breast. It is shaped such that less than full in the top and fuller in the lower part, to resemble a teardrop when viewed from the side. Therefore, it is known colloquially as a teardrop implant. teardrop shape gives the upper breast straight profile when viewed from the side, which is similar to what would have natural breasts, even if it is large. Therefore, the shape of the breast implants manufactured by the anatomy of a more natural and authentic-looking than those generated by the round implants, and makes it difficult to tell visually that the patient has breast implants. However, the anatomical implant does have some drawbacks. First, the silicone gel in the implants need to be sufficiently rigid to create and maintain the shape of a teardrop. This means that the implant will feel less soft than say, a round implant silicone gel that does not require to have these physical properties. Second, the gel stiffness means that quite resistant to gravity. Therefore, when the patient lies down, the teardrop shape is maintained, while the real breast shape will change when the patient lies down because the breast tissue will move up along the chest in a position in response to gravity. Losses third of the implant anatomy is that because it has a certain shape and not round, it should be positioned in the correct orientation, with the peak part of the incomplete at the top (in the 12 o'clock position) and a basic part of a more fully below (in the hour position 6). It can not tolerate that tilted or rotated to one side or the other, because this will have an adverse effect on the shape of the breast, causing it to look unnatural.
The third implant shape, known as Motiva Ergonomix®, has been available in Singapore since 2016. This is the sixth and latest generation of breast implants. Gel silicone in these implants have an ideal balance of viscosity (how it flows by gravity), cohesively (how well the gel remains intact without breaking), elasticity (how good is returned to its original state after being stretched), and viscoelasticity (how flexible and adaptable it) , The combination of physical characteristics allows the implant Ergonomix to change and adapt its shape in response to the force of gravity. It looks like implant rotation when lying down, and it looks like implant anatomy when standing. It is also much softer than the two other implants. Thus, the softest and most natural-looking implants with the most natural movements. In addition, no matter rotation Motiva implants as Ergonomix® round basis and will not cause distortion in breast shape no matter what orientation it and how much it is played.
Different Breast Implant Projections for Breast Enhancement
Projections implant refers to how much it causes the breast to the project profile to the front when placed in the patient. Lower projections create a flat looking breasts that do not stand out much in profile, while the higher projection creates a more prominent profile with a breast projecting forward to a greater extent. In the span of Ergonomix® Motiva implants, for example, four levels of projection are available: low, medium, full, and full extras. The ideal implant projection is determined by a combination of patient preferences and characteristics of the anatomy of the breast and chest.
Different Breast Implant Surfaces for Breast Enhancement
In general, there are two types of breast implant surfaces: smooth and textured. Historically, attention to the issue of the implant surface comes from concern over the complications associated with this type of implant surfaces. The main complication in question is capsular contracture.
What is Capsular Contracture?
When the implant is placed in the body, the immune system reacts to the presence of the implant and the initiation of an immunological chain of events that produce inflammation and scar tissue layers are produced around the implant. This layer of scar tissue around the implant known as a capsule. If the capsule is thin and soft, does not cause problems. On the other hand, if the capsule thickens and contracts, it compresses the implant, causing it to feel too firm and distort the shape becomes too round. This is known as a complication of capsular contracture. Although not dangerous complications, it compromises the aesthetic result of breast augmentation procedure, and usually require reoperation to address them.
Smooth Implants
The original and the first generation of breast implants are made with a smooth surface. However, he observed that this implant produces a relatively high rate of capsular contracture, and it is believed that capsular contracture is caused by the smooth surface of the implant.
Macro textured implants
Concerns over the high levels of capsular contracture smooth implant led to the development of implant surfaces textured with confidence that rough texturing of the implant surface will result in a lower incidence of capsular contracture. Clinical studies seem to indicate that textured implants did produce a lower rate of capsular contracture. However, textured implants then became associated with other complications such as sermons and anaplastic large cell lymphoma (AlCl). A seroma is a collection of fluid serum (blood without red blood cells) around the implant, while AlCl is a type of lymphoma (cancer of the lymph nodes). Smooth implants are not associated with seromas and AlCl.
Motiva’s SilkSurface Implant
The Motiva Ergonomix® implants have a very finely textured surface known as the SilkSurface. This texturing is so fine that it is measured in nanometers and it feels almost smooth. In fact, officially classified as a smooth surface. It has been shown in scientific studies that excellent texturing of the implant shell results in the body's tissues reacted positively to the presence of the implant. The body does not produce a lot of inflammation in response to the implant and consequently, capsules scar tissue that forms around the implant is thin and soft, so that a very low risk of capsular contracture. In addition, there has been no case seromas or AlCl associated with Motiva implants.
Which breast implant is best for you?
The choice of implant should be made after considering all the pros and cons of each type of implant shape and surface in consultation with a certified, accredited and experienced plastic surgeon, after which you will be able to make a properly informed decision for yourself.
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